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Bannerjee's review in 2009 confirmed concerns over the use of antipsychotic drugs to treat the behavioural and psychological symptoms of dementia (BPSD) in older people.1 Antipsychotic drugs are associated with an increased risk of stroke and overall greater mortality when used in this population.2 The cerebrovascular risk is increased further in vascular dementia.3 With the exception of risperidone, antipsychotic drugs prescribed for BPSD are being used outside the product licence. The National Institute for Health and Clinical Excellence (NICE) recommends that antipsychotic medication should not be used first line in the management of mild BPSD, but may be offered first line for managing severe symptoms.3 Risperidone has marketing authorisation for the short-term treatment (up to 6 weeks) of persistent aggression in patients with moderate to severe Alzheimer's dementia unresponsive to non-pharmacological approaches and when there is a risk of harm to self or others.4 The risks and benefits of treatment should be discussed with the patient and their carers taking into consideration the accessible information standard and informed consent to …